This study examined the changes in cortisol levels and psychological distress symptoms of 83 nonclinical subjects receiving a single hourlong intervention. Subjects were randomly assigned to either an emotional freedom technique (EFT) group, a psychotherapy group receiving a supportive interviews (SI), or a no treatment (NT) group. Salivary cortisol assays were performed immediately before and 30 minutes after the intervention. Psychological distress symptoms were assessed using the symptom assessment-45. The EFT group showed statistically significant improvements in anxiety (−58.34%, p < 0.05), depression (−49.33%, p < 0.002), the overall severity of symptoms (−50.5%, p < 0.001), and symptom breadth (−41.93%, p < 0.001). The EFT group experienced a significant decrease in cortisol level (−24.39%; SE, 2.62) compared with the decrease observed in the SI (−14.25%; SE, 2.61) and NT (−14.44%; SE, 2.67) groups (p < 0.03). The decrease in cortisol levels in the EFT group mirrored the observed improvement in psychological distress.
EFT in Biochemistry Papers
This area represents the clinical research on EFT in biochemistry papers. Where the paper is available free of charge in an open access journal, you can download it and use freely (on website, social media, newsletters). If it is behind a pay wall, you can freely share the abstract and reference but cannot share the full article, due to copyright.
The Effect of Emotional Freedom Techniques on Stress Biochemistry: A Randomized Controlled Trial
Abstract
Citation (APA Style): Church, D., Yount, G., & Brooks, A. J. (2012). The effect of emotional freedom techniques on stress biochemistry. Journal of Nervous & Mental Disease, 200(10), 891–896. https://doi.org/10.1097/nmd.0b013e31826b9fc1
Direct link: https://journals.lww.com/jonmd/abstract/2012/10000/the_effect_of_emotional_freedom_techniques_on.12.aspx
Reexamining the Effect of Emotional Freedom Techniques on Stress Biochemistry: A Randomized Controlled Trial
Abstract
Objective: In a direct replication of Church, Yount, and Brooks (2012), this study examined changes in stress biochemistry and psychological distress symptoms in 53 participants randomly allocated to one of three 60-min group interventions: Emotional Freedom Techniques (EFT), psychoeducation (PE), and no treatment (NT). The Symptom Assessment-45 (SA-45) was used to assess psychological distress symptoms.
Method: Salivary cortisol assays were administered 30 min pre- and postintervention to test cortisol levels. The original study by Church et al. indicated the EFT group showed statistically significant improvements in anxiety (-58.34%, p < .05), depression (-49.33%, p < .002), overall severity of symptoms (-50.5%, p < .001), and symptom breadth (-41.93%, p < .001). The group also experienced a significant decrease in cortisol (-24.39%) compared to the PE group (-14.25%) and NT group (-14.44%).
Results: The present results indicated the EFT group experienced a significant decrease in cortisol greater than the original study (-43.24%, p < .05), but these results were not mirrored by subjective reports of psychological distress. The EFT group reduction in cortisol was significantly different from that of the PE group (-19.67%), and as expected, the posttreatment cortisol level detected among the EFT group was lower than that of the NT group (2.02%); however, there was not a statistically significant difference between the 2 groups. Additionally, there were no significant improvements in cortisol reduction among the NT and PE groups.
Conclusions: Findings support the original study indicating EFT to be an efficient and effective brief treatment for reducing biological markers of stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Citation (APA Style): Stapleton, P., O’Neill, H. M., Sabot, D., & Crighton, G. (2020). Reexamining the effect of emotional freedom techniques on stress biochemistry: A randomized controlled trial. Psychological Trauma, 12(8), 869–877. https://doi.org/10.1037/tra0000563
Direct link: https://psycnet.apa.org/doiLanding?doi=10.1037%2Ftra0000563
Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health
Abstract
Emotional Freedom Technique (EFT) is an evidence-based self-help therapeutic method and over 100 studies demonstrate its efficacy. However, information about the physiological effects of EFT is limited. The current study sought to elucidate EFTs mechanisms of action across the central nervous system (CNS) by measuring heart rate variability (HRV) and heart coherence (HC); the circulatory system using resting heart rate (RHR) and blood pressure (BP); the endocrine system using cortisol, and the immune system using salivary immunoglobulin A (SigA). The second aim was to measure psychological symptoms. Participants (N = 203) were enrolled in a 4-day training workshop held in different locations. At one workshop (n = 31), participants also received comprehensive physiological testing. Posttest, significant declines were found in anxiety (-40%), depression (-35%), posttraumatic stress disorder (-32%), pain (-57%), and cravings (-74%), all P < .000. Happiness increased (+31%, P = .000) as did SigA (+113%, P = .017). Significant improvements were found in RHR (-8%, P = .001), cortisol (-37%, P < .000), systolic BP (-6%, P = .001), and diastolic BP (-8%, P < .000). Positive trends were observed for HRV and HC and gains were maintained on follow-up, indicating EFT results in positive health effects as well as increased mental well-being.
Citation (APA style): Bach, D., Groesbeck, G., Stapleton, P., Sims, R., Blickheuser, K., & Church, D. (2019). Clinical EFT (emotional freedom techniques) improves multiple physiological markers of health. Journal of Evidence-Based Integrative Medicine, 24, 2515690X18823691. https://doi.org/10.1177/2515690X18823691
Direct link: https://journals.sagepub.com/doi/10.1177/2515690X18823691
Physiological Mechanisms of Energy Psychology Treatments: An Updated Synthesis
Abstract
Background: Energy psychology encompasses a range of treatments that utilize somatic interventions to promote psychological change by influencing the body’s electromagnetic signaling systems. The most popular and systematically investigated of these modalities is Emotional Freedom Techniques (EFT). The distinctive feature of the approach is the stimulation of acupuncture points (acupoints) by having the client tap on them while simultaneously using words and imagery that evoke clinically relevant memories, emotions, and cognitions. Strong outcomes using the approach have been documented in more than 200 peer-reviewed clinical trials. While tapping on the body to heal emotional trauma or to change longstanding behavioral patterns is an unconventional approach, this growing body of efficacy evidence warrants scrutiny into potential mechanisms of action.
Methods:While speculation about how the procedures involved in energy psychology protocols produce strong outcomes has taken many directions, areas of consensus have been emerging in relation to the physiological mechanisms underlying the approach.This paper synthesizes current literature to identify these probable physiological mechanisms.
Results:Seven empirically supported premises that provide insight into the physiological mechanisms were derived from the peer-reviewed energy psychology literature with supportive material drawn from pertinent publications in psychology, physiology, and neurology:
- Biological markers demonstrating clinical improvements consistently follow acupoint tapping sessions.
- Tapping on an acupoint generates electromagnetic signals
- These signals are transmitted via afferent nerves and connective tissue to the brain.
- The signals reach brain regions that are activated by the words, thoughts, memories, and images paired with the tapping.
- The signals upregulate or downregulate clinically relevant brain regions, promoting homeostasis, balance, and adaptive behavior.
- This process aligns with the mechanisms of memory reconsolidation, explaining durable cognitive and behavioral shifts.
- Tapping on acupuncture points during imaginal exposure makes imaginal exposure more effective.
Conclusion: While further research is needed, the existing literature offers plausible physiological explanations for the documented positive mental health outcomes following the application of acupoint tapping protocols.
Citation (APA Style): Feinstein, D. (2025). Physiological mechanisms of energy psychology: An updated synthesis. Energy Psychology: Theory, Research, and Treatment, 17. https://doi.org/10.9769/EP.2025.17.1.DF
Direct link: https://energypsychologyjournal.org/physiological-mechanisms-of-energy-psychology-treatments-an-updated-synthesis/
How Tapping into “Energy” Can Trigger a Paradigm Shift in Biomedicine
No abstract available.
Citation (APA Style): Leskowitz, E. (2018). How tapping into “energy” can trigger a paradigm shift in biomedicine. The Journal of Alternative and Complementary Medicine, 24(6), 525–527. https://doi.org/10.1089/acm.2018.0073
Differential Gene Expression after Emotional Freedom Techniques (EFT) Treatment: A Novel Pilot Protocol for Salivary mRNA Assessment
Abstract
Biopsychology is a rapidly expanding field of study since the completion of the Human Genome Project in 2003. There is little data measuring the effect of psychotherapeutic interventions on gene expression, due to the technical, logistical, and financial requirements of analysis. Being able to measure easily the effects of therapeutic experiences can validate the benefits of intervention. In order to test the feasibility of gene expression testing in a private practice setting, this study compared messenger ribonucleic acid (mRNA) and gene expression before and after psychotherapy and a control condition. With four non-clinical adult participants, it piloted a novel methodology using saliva stored at room temperature. A preliminary test of the interleukin- 8 (IL8) gene in both blood and saliva was performed in order to determine equivalency in the two biofluids; convergent validity was found. Following saliva test validation, a broad, genome-wide analysis was performed to detect differential gene expression in samples collected before and after treatment with Emotional Freedom Techniques (EFT), an evidence-based practice combining acupressure and cognitive exposure. The control treatment was non-therapeutic social interaction. To establish a baseline, participants received the control first, followed a week later by EFT. Analysis of samples was performed at three time points: immediately before treatment, immediately after, and 24 hours later. Differential expression between EFT and control was found in numerous genes implicated in overall health (p < 0.05). Further, the differentially expressed genes in this study were shown to be linked to immunity, pro or anti-inflammatory, as well as neuronal processes in the brain. Ten of the 72 differentially expressed genes are identified as promising targets for downstream research. The data show promise for the future use of salivary samples to determine the effects of therapy; this pilot protocol also illustrated the challenges and limitations of novel technologies employed in biopsychology.
Citation (APA Style): Maharaj, M. E. (2016). Differential gene expression after emotional freedom techniques (EFT) treatment: A novel pilot protocol for salivary mRNA assessment | energy psychology journal. Energy Psychology Journal, 8, 17–32. https://doi.org/10.9769/EPJ.2016.8.1.MM
Epigenetic Effects of PTSD Remediation in Veterans Using Clinical Emotional Freedom Techniques: A Randomized Controlled Pilot Study
Abstract
Purpose: To assess the feasibility of measuring changes in gene expression associated with post-traumatic stress disorder (PTSD) treatment using emotional freedom techniques (EFT).
Design: Participants were randomized into an EFT group receiving EFT and treatment as usual (TAU) throughout a 10-week intervention period and a group receiving only TAU during the intervention period and then receiving EFT.
Setting: A community clinic and a research institute in California.
Participants: Sixteen veterans with clinical levels of PTSD symptoms.
Intervention: Ten hour-long sessions of EFT.
Measures: Messenger RNA levels for a focused panel of 93 genes related to PTSD. The Symptom Assessment 45 questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Scale, SF-12v2 for physical impairments, and Rivermead Postconcussion Symptoms Questionnaire.
Analysis: Pre-, posttreatment, and follow-up mean scores on questionnaires were assessed using repeated measures 1-way analysis of variance. A Student t test and post hoc analyses were performed on gene expression data.
Results: Post-traumatic stress disorder symptoms declined significantly in the EFT group (-53%, P < .0001). Participants maintained their gains on follow-up. Significant differential expression of 6 genes was found ( P < .05) when comparing the expression levels before and after the intervention period in participants receiving EFT.
Conclusion: Study results identify candidate gene expression correlates of successful PTSD treatment, providing guidelines for the design of further studies aimed at exploring the epigenetic effects of EFT.
Citation (APA Style): Church, D., Yount, G., Rachlin, K., Fox, L., & Nelms, J. (2018). Epigenetic effects of PTSD remediation in veterans using Clinical Emotional Freedom Techniques: A randomized controlled pilot study. American Journal of Health Promotion: AJHP, 32(1), 112–122. https://doi.org/10.1177/0890117116661154
Epigenetic Effects of PTSD Remediation in Veterans Using Clinical Emotional Freedom Techniques: A Randomized Controlled Pilot Study
Abstract
Purpose: To assess the feasibility of measuring changes in gene expression associated with post-traumatic stress disorder (PTSD) treatment using emotional freedom techniques (EFT).
Design: Participants were randomized into an EFT group receiving EFT and treatment as usual (TAU) throughout a 10-week intervention period and a group receiving only TAU during the intervention period and then receiving EFT.
Setting: A community clinic and a research institute in California.
Participants: Sixteen veterans with clinical levels of PTSD symptoms.
Intervention: Ten hour-long sessions of EFT.
Measures: Messenger RNA levels for a focused panel of 93 genes related to PTSD. The Symptom Assessment 45 questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Scale, SF-12v2 for physical impairments, and Rivermead Postconcussion Symptoms Questionnaire.
Analysis: Pre-, posttreatment, and follow-up mean scores on questionnaires were assessed using repeated measures 1-way analysis of variance. A Student t test and post hoc analyses were performed on gene expression data.
Results: Post-traumatic stress disorder symptoms declined significantly in the EFT group (-53%, P < .0001). Participants maintained their gains on follow-up. Significant differential expression of 6 genes was found ( P < .05) when comparing the expression levels before and after the intervention period in participants receiving EFT.
Conclusion: Study results identify candidate gene expression correlates of successful PTSD treatment, providing guidelines for the design of further studies aimed at exploring the epigenetic effects of EFT.
Citation (APA Style): Church, D., Yount, G., Rachlin, K., Fox, L., & Nelms, J. (2018). Epigenetic effects of PTSD remediation in veterans using Clinical Emotional Freedom Techniques: A randomized controlled pilot study. American Journal of Health Promotion: AJHP, 32(1), 112–122. https://doi.org/10.1177/0890117116661154
Emotional Freedom Techniques for Elderly Patients with COVID-19: A Case Series on Clinical Recovery, Frailty, and Inflammatory Biomarkers
Abstract
Background/Objectives: Older adults are disproportionately affected by COVID-19 due to immunosenescence and comorbidities, resulting in higher rates of severe illness and mortality. Psychological distress such as anxiety and fatigue further compounds disease burden. Emotional Freedom Techniques (EFT), an integrative psychophysiological approach, has shown potential in enhancing psychological resilience and modulating inflammatory responses.
Methods: We report a case series of five elderly patients with confirmed COVID-19 admitted to Persahabatan Hospital, Jakarta. Each received standard pharmacological care, including antiviral therapy, corticosteroids, and comorbidity management, alongside daily EFT sessions combining acupressure, affirmations, and exposure techniques. Clinical symptoms, frailty status (via WHAS criteria), WHO Ordinal Scale for Clinical Improvement (OSCI), and serum IL-6 levels were monitored over a 30-day follow-up period. Emotional well-being was qualitatively assessed through follow-up interviews and therapist observations of patient engagement and affective behavior.
Results: All patients demonstrated substantial clinical improvement. OSCI scores decreased from baseline values of 3–4 to 1 by the final follow-up, representing a 66–75% reduction in clinical severity. Frailty status improved markedly across all cases. IL-6 levels showed an average reduction of approximately 85%, suggesting a clinically meaningful improvement in systemic inflammation. No residual symptoms or adverse events were reported. Patients also demonstrated enhanced emotional well-being and adherence to EFT through digital guidance.
Conclusion: EFT may serve as a safe and supportive adjunct therapy in elderly COVID-19 patients, potentially accelerating clinical recovery and reducing inflammation and frailty. Further controlled trials are warranted to evaluate broader applicability in geriatric care.
Citation (APA Style): Kemala Sari, N., Burhan, E., Isbaniah, F., Yennita, D., & Stepvia, S. (2025). Emotional freedom techniques for elderly patients with COVID-19: A case series on clinical recovery, frailty, and inflammatory biomarkers. Frontiers in Psychology, 16. https://doi.org/10.3389/fpsyg.2025.1627592
Direct link: https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2025.1627592/full